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Miscellaneous: Claims Adjustments
Claims
Claims Adjustments
Claims
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CHARGES
COB
DATE
DIAGNOSIS
MEDICARE
PLACE
PROCEDURE
PROVIDER
SUBSCRIBER
E
B
P
W
U
D
A
E
Y
W
S
C
H
B
R
X
M
R
S
A
U
X
A
E
G
Z
E
A
E
H
B
T
D
L
R
E
T
C
G
P
S
R
I
G
P
U
A
I
R
X
C
E
A
Q
M
P
D
D
A
N
R
D
G
M
K
T
F
E
H
D
I
I
N
Y
H
U
F
M
C
O
B
V
O
W
Y
W
R
Z
P
O
E
O
S
D
P
M
Z
N
L
Q
R
R
I
G
P
X
L
L
M
V
M
P
S
Q
J
A
O
D
A
L
A
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